When a prescription is received or issued under delegation, such as a medical directive, who is the prescriber on the dispensing record – the prescriber or the person who signed it?
The Regulated Health Professions Act has provisions to allow a regulated health professional to delegate their authority to perform a controlled act to a person (regulated or not) who does not have that authority. Delegation of authority can be implemented by use of a Direct Order or a Medical Directive. In this case, the controlled act is “prescribing”.
The College’s Medical Directives and the Delegation of Controlled Acts Policy sets out the expectations for registrants who are considering authorizing or implementing delegated acts.
A prescription issued pursuant to a directive must include the:
- Name of prescriber (delegator; authorizer of the directive)
- Name and signature/unique authorization of the person issuing the prescription (delegate; implementer of the directive)
- Name and number of the medical directive
- Contact information for the authorizer and implementer
The prescriber’s name (delegator; authorizer of the directive) should be recorded on the dispensing record as they are ultimately responsible for the prescription, even though they have delegated the authority to perform the act to someone else to implement via a directive.
Should there be questions about the prescription, registrants should contact the implementer. If the questions cannot be resolved, the prescriber would be contacted for clarification. Where requested, a copy of the directive may also be forwarded to the pharmacy.
More information can be found in the Health Professions Regulators of Ontario Interprofessional Guide, FAQ, and templates.